Management of Sleep Apnea Patients by a Clinical Nurse (Supernurse)
Study Details
Study Description
Brief Summary
Sleep apnea is a prevalent problem and references for the evaluation of this condition often exceeds the sleep clinic's capacity thus creating important delays in the patients' care.
The overall goal of this project is to assess the feasibility and the non-inferiority of integrating a clinical nurse, or supernurse, to the initial consultation team.
The hypothesis is that the integration of a clinical nurse to the sleep clinic's evaluation team is non inferior in terms of patients' outcomes such as improvement of symptoms and quality of life as well as adherence to treatment.
This study is supported by funding dedicated to teaching and research activities related to sleep-disordered breathing.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Multidisciplinary arm Patients randomized in this group will have their first sleep clinic evaluation with the clinical nurse. She will then discuss each case with the pulmonologist and validate the diagnostic and therapeutic avenue. |
Other: Clinical nurse (supernurse) evaluation
The first evaluation of the patient refered to the sleep clinic will be performed by the clinical nurse then discussed with the pulmonologist in charge.
|
| Active Comparator: Pulmonologist arm Patients randomized in this group will have their first sleep clinic evaluation with the pulmonologist. |
Other: Pulmonologist evaluation
The first evaluation of the patient refered to the sleep clinic will be performed only by the pulmonologist.
|
Outcome Measures
Primary Outcome Measures
- Improvement in symptoms [Assessed at three months]
Based on the Epworth Sleepiness scale (ranging from 0 to 24 points, higher values indicates increased sleepiness)
- Improvement in symptoms [Assessed at six months]
Based on the Epworth Sleepiness scale (ranging from 0 to 24 points, higher values indicates increased sleepiness)
Secondary Outcome Measures
- Improvement in quality of life [Assessed at three months]
Based on the Quebec Sleep questionnaire
- Improvement in quality of life [Assessed at six months]
Based on the Quebec Sleep Questionnaire
- Positive pressure treatment adherence [Assessed at six months]
Number of hours used per night according to CPAP report
- Mandibular advancement device treatment adherence [Assessed at six months]
According to the patient's usage report
- Weight loss treatment adherence [Assessed at six months]
Changes from baseline weight (kg)
- Positional therapy [Assessed at six months]
Proportion of time spent supine at baseline and at control cardio-respiratory recording
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Patients referred to the ''Institut Universitaire de Cardiologie et Pneumologie de Québec'' 's sleep clinic who have undergone a cardiorespiratory polygraphy.
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Body mass index (BMI) between 27-35 kg/m2;
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Apnea-Hypopnea Index (ADI) equal or above 20 events per hour with less than 5 events per hour of central origin;
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Oxygen Desaturaton Index (ODI) equal or above 10 events per hour;
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Percentage of time spent below 90% of oxygen saturation equal or less than 10%
Exclusion criteria :
- Patients not meeting the above inclusion criteria.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec (CRIUCPQ) | Quebec City | Quebec | Canada | G1V4G5 |
Sponsors and Collaborators
- Annie C Lajoie
- Laval University
Investigators
None specified.Study Documents (Full-Text)
More Information
Publications
- Antic NA, Buchan C, Esterman A, Hensley M, Naughton MT, Rowland S, Williamson B, Windler S, Eckermann S, McEvoy RD. A randomized controlled trial of nurse-led care for symptomatic moderate-severe obstructive sleep apnea. Am J Respir Crit Care Med. 2009 Mar 15;179(6):501-8. doi: 10.1164/rccm.200810-1558OC. Epub 2009 Jan 8.
- Chai-Coetzer CL, Antic NA, Rowland LS, Catcheside PG, Esterman A, Reed RL, Williams H, Dunn S, McEvoy RD. A simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care. Thorax. 2011 Mar;66(3):213-9. doi: 10.1136/thx.2010.152801. Epub 2011 Jan 20.
- Chai-Coetzer CL, Antic NA, Rowland LS, Reed RL, Esterman A, Catcheside PG, Eckermann S, Vowles N, Williams H, Dunn S, McEvoy RD. Primary care vs specialist sleep center management of obstructive sleep apnea and daytime sleepiness and quality of life: a randomized trial. JAMA. 2013 Mar 13;309(10):997-1004. doi: 10.1001/jama.2013.1823.
- Robertson S, Maxwell C, McGarry GW, MacKenzie K. A nurse-led snoring clinic: how we do it. Clin Otolaryngol. 2009 Apr;34(2):158-61. doi: 10.1111/j.1749-4486.2009.01898.x.
- Tomlinson M, John Gibson G. Obstructive sleep apnoea syndrome: a nurse-led domiciliary service. J Adv Nurs. 2006 Aug;55(3):391-7.
- Sleep Apnea Supernurse